Surgeon infected patients during heart procedure, Cedars-Sinai admits

A heart surgeon at Cedars-Sinai Medical Center unwittingly infected five patients during valve replacement surgeries earlier this year, causing four of the patients to need a second operation.

The infections occurred after tiny tears in the latex surgical gloves routinely worn by the doctor allowed bacteria from a skin inflammation on his hand to pass into the patients' hearts, according to the hospital. The patients survived the second operation and are still recovering, hospital officials said.

The outbreak led to investigations by the hospital and both the L.A. County and California departments of public health. The federal Centers for Disease Control and Prevention was also consulted.

Hospital officials called it a "very unusual occurrence" probably caused by an unfortunate confluence of events: the nature of the surgery, the microscopic rips in the gloves and the surgeon's skin condition. Valve replacement requires the surgeon to use thick sutures and tie more than 100 knots, which can cause extra stress on the gloves, they said.

Nevertheless, the hospital's goal is to have zero infections, said Harry Sax, vice chairman of the hospital's department of surgery. "Any hospital-acquired infection is unacceptable," he said.

The infections raise questions about what health conditions should prevent a surgeon from operating and how to get the best protection from surgical gloves. Surgeons with open sores or known infections aren't supposed to operate, but there is no national standard on what to do if they have skin inflammation, said Rekha Murthy, medical director of the hospital's epidemiology department. She added that there were also no national standards on types of gloves used, whether to wear double gloves or how many times surgeons should change those gloves during a procedure.

Healthcare-acquired infections are very common throughout the United States. Each year, infections cause 99,000 deaths in the country, including about 12,000 in California. Hospitals in the state are required to report certain infections to the California Department of Public Health. That reporting makes the public more aware of the quality of care provided at local hospitals and is an important tool for reducing infections, said Debby Rogers, deputy director of the department's Center for Health Care Quality.

Cedars-Sinai has low rates for hospital-acquired infections compared with the state and national average but has not performed as well on other surgical quality measures recently, according to the Leapfrog Group, an employer-backed nonprofit focused on healthcare quality. The organization gave the hospital a C rating last month on its national report card, down from an A in June, though it was not related to the infection outbreak.

"Clearly this hospital is making attempts to reduce infections, but they have more work to do," said Leah Binder, Leapfrog's chief executive.

Cedars-Sinai Medical Center conducts about 360 valve replacement surgeries each year and said infections occur in fewer than 1% of its cases — lower than the national average.

The hospital learned about the problem in June after three patients who had undergone valve replacement surgery showed signs of infection. Doctors diagnosed the patients with an infection called endocarditis. Concerned there might be a connection among the cases, epidemiologists analyzed the bacteria, staphylococcus epidermidis, and determined that it was an identical strain and therefore must have come from a single source. "It led to the question of gee, I wonder where it came from?" Murthy said.

Epidemiologists homed in on the surgeon with the skin inflammation. The bacteria matched, and then they made a surprising discovery: microscopic tears in the gloves typically worn by surgeons after performing valve replacement surgery. The surgeon, whose name was not released, was not allowed to operate again until he healed. He is still a member of the medical staff but no longer performs surgeries at the hospital.

The hospital soon found the same infection in two more patients. Officials also reached out to 67 patients who had heart valve replacements with the same surgeon but didn't find any other cases. One of the five infected patients was treated with antibiotics, and the other four had new valve replacement surgeries. Sax said the hospital apologized to the patients and has continued to monitor their health. The hospital has also covered the cost of their care, including follow-up treatment and all the related surgeries.

All surgeons doing valve replacements are now required to change gloves more frequently, officials said. Some surgeons are wearing double gloves during the operations, Sax said.

Following the outbreak, Cedars-Sinai did the proper follow-up to ensure the safety of their patients, said Dawn Terashita, a medical epidemiologist with L.A. County, who was notified in September. What occurred at Cedars-Sinai was an unintentional consequence of the surgery, she said.

"There is no way to keep a room entirely sterile and all the people in it sterile," she said. "You will always have risk of infection."

anna.gorman@latimes.com

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15 Agonizing Automotive Atrocities

Yugo.

There, we got it out of the way. When you read the headline, of course an image of a tiny Cold War-era hatchback popped into your head. We bet you also shuddered at the thought of a Pontiac Aztek.

We love to poke fun at failure, and no failure made a punchline better than the Yugo. We found that out while talking with Jason Vuic, author of The Yugo: The Rise and Fall of the Worst Car in History. Vuic was aware that the Yugo fell far short of being a good car, but what truly amazed him was how many people who had never driven a Yugo knew just how bad it was. In failure, it became a wild viral marketing success.

Not all cars rose to level of infamy embodied by the Yugo. To paraphrase Shakespeare, some cars were born awful while others had awfulness thrust upon them. Some automotive atrocities were the result of automakers trying something new and falling far short of the mark, while other cars failed from a lack of effort. Still others were perfectly adequate cars but came to represent a regrettable moment in time.

Here we display all three kinds of auto-trocities, highlighting famous failures and digging deep to dredge up detritus better off forgotten. Yes, we know there are many, many more automotive atrocities and this list only scratches the surface of the heap. You’ll have a chance to list your favorite heaps tomorrow, so stay tuned.

Above: Peel Trident 1965-1966

Famous from appearances on Top Gear and Monster Garage, the Peel Trident was a “shopping car” built on the Isle of Man. Along with the bubblelicious BMW Isetta and the fiberglass Reliant Robin, the Trident was ridiculed for its small size and three wheels.

Photo: Casaflamingo/Flickr

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Reinhold Weege, creator of “Night Court,” dies at 63

LOS ANGELES (TheWrap.com) – Reinhold Weege, the creator of the hit NBC sitcom “Night Court,” has died, a spokeswoman for the family told TheWrap. He was 63 years old.

He also wrote for other notable television shows, including “Barney Miller” and “M*A*S*H.”

However, it was “Night Court,” a show that poked gentle fun at bureaucratic absurdity, that would become his signature work. The series centered on a young judge (Harry Anderson) saddled with handling the bottom of the barrel cases that come into Manhattan’s night court and featured a breakout performance by John Larroquette as a skirt-chasing lawyer.

The show started out tackling serious legal issues, but over the course of its nine seasons, slowly expunged commentary in favor of broad humor.

Weege might never have entered show business had he not been fired from a job in journalism. In a 1994 piece in the Chicago Tribune, he wrote that he was working as a reporter and editor of a tiny suburban paper when he reported on a secret meeting, between the town and the Pritzker hotel chain about a proposal to build a monorail, hotels and a 60-story office building.

After his paper was less than thrilled with the piece he copyrighted it and had it picked up by a larger paper — the result was he got canned.

“Shortly after that, I sold our couch, the only asset my wife and I had, got in the car and headed toward Hollywood,” Weege wrote.

The rest is history.

Weege is survived by his ex-wife Shelley, two daughters and a granddaughter.

TV News Headlines – Yahoo! News

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7.3 quake off Japan prompts tsunami warning

TOKYO—

A strong earthquake struck Friday off the coast of northeastern Japan in the same region that was hit by a massive earthquake and tsunami last year. A city in the region reported that a small tsunami had hit, but there were no immediate reports of injuries or damage.

The Japan Meteorological Agency said the earthquake had a preliminary magnitude of 7.3 and struck in the Pacific Ocean off Miyagi prefecture at 5:18 p.m. (0818 GMT). The epicenter was 6.2 miles beneath the seabed.

After the quake, which caused buildings in Tokyo to sway for at least several minutes, authorities issued a warning that a tsunami potentially as high as 2.19 yards could hit. Ishinomaki, a city in Miyagi, reported that a tsunami of 1 yard hit at 6:02 p.m. (0902 GMT).

The Pacific Tsunami Warning Center said there was no risk of a widespread tsunami.

Miyagi prefectural police said there were no immediate reports of damage or injuries from the quake or tsunami, although traffic was being stopped in some places to check on roads.

Shortly before the earthquake struck, NHK television broke off regular programming to warn that a strong quake was due to hit. Afterward, the announcer repeatedly urged all near the coast to flee to higher ground.

The magnitude-9.0 earthquake and ensuing tsunami that slammed into northeastern Japan on March 11, 2011, killed or left missing some 19,000 people, devastating much of the coast. All but two of Japan's nuclear plants were shut down for checks after the earthquake and tsunami caused meltdowns at the Fukushima Dai-Ichi nuclear plant in the worst nuclear disaster since the 1986 Chernobyl disaster.

Immediately following Friday's quake, there were no problems at any of the nuclear plants operated by Fukushima Dai-Ichi operator Tokyo Electric Power Co., said a TEPCO spokesman, Takeo Iwamoto.

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Apple Builds a New Home on Facebook's Back Porch

We knew that Apple was building a pair of new data centers close to Facebook’s operation in Prineville, Oregon. But we didn’t realize just how close they were until we spent a plane over Oregonian high desert.

The notoriously secretive Apple is especially secretive about its data centers. So while Google and Facebook have opened up their doors to Wired reporters over the past year, Apple has not only rolled up the welcome mat. They’ve disconnected the front doorbell.

That’s what forced us to take to the skies. In April, we published our first overhead shots of Apple’s Maiden, North Carolina, data center, and a few weeks ago, we sent our iSpy plane over Prineville, where Apple has just broken ground on a $68 million data center, just down the road from Facebook.

So here’s the world’s first look at the future home of the West Coast iCloud:

You can see Apple’s mini data center — they call it a tactical data center — up in the northeast corner of the property. Here’s a close-up shot:

Apple finished this building earlier this year, but just south of it, you can see what will be the site of its much larger 338,000-square-foot data center. Apple wants to eventually build two of these monster data centers on the 160-acre site, but right now, there’s no sign of the second facility.

When it goes fully online, Prineville will be fully powered by alternative energy. That might help cut it some slack from Greenpeace, which has been known to launch unexpected protests on Apple property armed with window-washers and black balloons.

Apple showed up in Prineville only after Facebook had built its own 330,000-square-foot data center just outside of town. The internet giants love locations like this, primarily because of their cheap real estate, local tax breaks, cool climates, and reliable and abundant power supplies.

Facebook’s first data center was up and running a year ago. The company is now putting the finishing touches on a second data center (at the bottom of the photo below) and has also broken ground on a new cold-storage facility, which is designed to save power by icing backup data on servers that are only rarely switched on. That smoothed-out rectangular patch just beneath the second data center is the future site of cold storage:

Apple operates three other data centers: in Newark, California; in Maiden, North Carolina; and at the company’s Cupertino headquarters. Earlier this year, it started work on a fifth facility in Reno, Nevada.

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Deportation looms for tech guru McAfee after heart drama

GUATEMALA CITY (Reuters) – Software guru John McAfee, fighting deportation to Belize, was rushed to a hospital in Guatemala on Thursday shortly after his asylum request was rejected, but a suspected heart attack turned out to be stress in a fresh twist to the saga.

The 67-year-old U.S. computer software pioneer was taken swiftly from a hospital in a police car out of the sight of media, after earlier arriving in an ambulance lying on a stretcher.

His lawyer said he was being taken back to an immigration department cottage where he has been detained since crossing illegally into Guatemala from neighboring Belize, where police want to question him in connection with his neighbor’s murder.

“He never had a heart attack, nothing like that,” said Telesforo Guerra, a former attorney general who had earlier said McAfee had two mild heart attacks.

“I’m not a doctor. I’m just telling you what the doctors told me,” he added. “He was suffering from stress, hypertension and tachycardia (an abnormally fast heartbeat).”

McAfee was posting on his blog www.whoismcafee.com in the morning, the time he suffered the stress attack.

“I don’t think a heart attack prevents one from using one’s blog,” Guerra had said at the time.

Guerra’s assistant, Karla Paz, earlier said she found McAfee lying on the ground and unable to move his body or speak.

McAfee was detained by Guatemalan police on Wednesday for illegally sneaking across the border with his 20-year-old girlfriend to escape authorities in Belize. He has said he fears authorities in Belize will kill him if he returns.

Guatemala’s foreign minister, Harold Caballeros, said earlier McAfee’s request for asylum was rejected.

Constitutional lawyer Gabriel Orellana, a former foreign minister, said the government should have given more weight to the asylum request rather than rush to a decision.

“We should take into account the fact that McAfee has not been accused of any crime in Belize,” he said.

QUARRELED WITH FELLOW AMERICAN

Police in Belize want to quiz McAfee as “a person of interest” in the killing of a fellow American, Gregory Faull, with whom he had quarreled. But they say he is not a prime suspect in the probe.

McAfee says he has been persecuted by Belize’s ruling party because he refused to pay around $ 2 million he says it is trying to hustle out of him, he said.

Belize’s prime minister denies this and said McAfee, who made millions from the Internet anti-virus software that bears his name, was “bonkers.” McAfee later lost much of his fortune and turned to a life of semi-reclusion by the Belizean beach.

McAfee spent Wednesday night reading his blog and posting his thoughts on a laptop he said was lent to him by the warden of the cottage where he was staying.

One person asked him if he felt like committing suicide.

“I enjoy living, and suicide is absurdly redundant,” he wrote. “The world, from the very beginning, hurls viruses, accidents, hungry animals, defective DNA – and uncountable more – in an attempt to kill us. It always succeeds. Suicide is simply aiding and abetting.”

McAfee’s earlier posts spoke of his relief at arriving in Guatemala, thinking he had found a way out of his troubles.

One of his readers posted a message offering him just that.

“John. I have a special ops team near the La Aurora International Airport. I can get you out of jail and provide safe passage back to the States for a fee. Please let me know if this interests you.”

DRUG PAST

Guatemala’s government originally said the eccentric tech entrepreneur, who loves guns and young women and has tribal tattoos covering his shoulders, would be expelled to Belize within hours. But it later rowed back.

The U.S. State Department said it was aware of McAfee’s arrest and its embassy was providing “appropriate consular services,” but could not comment further.

On the island of Ambergris Caye, where McAfee has lived for about four years, residents and neighbors say he is eccentric and at times unstable. He was seen to travel with armed bodyguards, sporting a pistol tucked into his belt.

The predicament of the former Lockheed systems consultant is a far cry from his heyday in the late 1980s, when he started McAfee Associates. McAfee has no relationship now with the company, which was sold to Intel Corp.

McAfee was previously charged in Belize with possession of illegal firearms, and police had raided his property on suspicions that he was running a lab to produce illegal synthetic narcotics. He says he has not taken drugs since 1983.

“I took drugs constantly, 24 hours of the day. I took them for years and years. I was the worst drug abuser on the planet,” he told Reuters just before his arrest. “Then I finally went to Alcoholics Anonymous, and that was the end of it.”

(With reporting by Andrew Quinn in Washington; Writing by Simon Gardner and Dave Graham; Editing by Doina Chiacu and Philip Barbara)

Celebrity News Headlines – Yahoo! News

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Economix Blog: Uwe E. Reinhardt: How Medicare Is Misrepresented

Uwe E. Reinhardt is an economics professor at Princeton. He has some financial interests in the health care field.

A common phrase in the current debate over the so-called fiscal cliff is “Medicare needs to be restructured.” The term serves as code for policies unlikely to be appealing to voters, a term that can mean everything and, thus, nothing.

The question is what problem restructuring is to solve in traditional Medicare, which remains one of the most popular health insurance programs in this country. People who use this vague term should always be challenged to explain exactly why and how Medicare should be changed.

Critics of traditional Medicare – even those who should know better – often accuse it of being “fee for service.” It is a strange accusation. After all, fee-for-service remains the dominant method of paying the providers of health care under private insurance, including Medicare Advantage, the option of private coverage open to all Medicare beneficiaries.

Describing Medicare as fee-for-service insurance is about as thoughtful as describing a horse as “an animal that has four legs,” a characteristic shared by many other animals. The practice is particularly odd, given that traditional Medicare as early as the 1970s was the first program to develop so-called “bundled payments” for hospital inpatient care – the diagnostically related groupings, known as D.R.G. – in place of fee-for-service payment of hospitals, an innovation that has since been copied around the globe.

A more descriptive term for traditional Medicare would be “free choice of providers” or “unmanaged care” insurance. These features, of course, would hardly be viewed as shortcomings among people covered by traditional Medicare or their families. Neither term would be a good marketing tool among voters for proposals to abandon traditional Medicare.

In this regard, it may be helpful to list the various contractual relationships that can exist between the insured and insurers, on the one hand, and the various methods of paying the providers of care, on the other:

Indemnity Insurance: This is the oldest form of health insurance. It offers the insured free choice of health care provider and of treatment, which is why such policies tend to be expensive.

Under indemnity insurance, providers of care are typically paid on a fee-for-service basis. Insurers usually pay a stipulated fraction (say 80 percent) of the providers’ bills for covered services. Patients absorb the rest in the form of deductibles and coinsurance (e.g., 20 percent of the providers’ bill). Under some policies, insurers ask patients to pay providers first and then seek reimbursement from the insurer.

Managed-Care Contracts: The other three insurance contracts shown in the display – H.M.O., P.P.O. and P.O.S. contracts – are generally lumped together under the generic term “managed care.” It is another ill-defined term that can mean a host of specific limitations on the insured’s freedom of choice.

Doctors may assert that it is they who manage the medical treatments. But in health-policy circles, the term managed care means that the doctor’s medical treatments are subject to external constraints imposed by a private regulator — the patient’s health insurer — although, in principle, public insurers could “manage” care as well, if legislators permitted it.

These externally imposed constraints may take the form of formularies for prescription drugs or prior authorization by the insurer for specific procedures – e.g., expensive imaging or elective surgery – before the insurer agrees to pay for the procedures. They may mean exclusion from coverage of procedures deemed by the insurer to have a low expected benefit-cost ratio. While Congress forbids Medicare to let cost-benefit analysis guide its coverage decisions, private insurers are not subject to that constraint.

Finally, managed care techniques might include the external coordination of medical treatments that involved multiple providers of health care, especially the treatment of chronic disease, often by subcontracted companies specializing in care coordination.

These are the major forms of managed care insurance contracts.

Health Maintenance Organizations (H.M.O.): These contracts represent the most restrictive form of managed care. The insurer provides covered health care benefits through a network of health care providers under contract to the insurer, with zero or very modest cost-sharing at point of service on the part of the insured.

In a staff model H.M.O., the insurer actually owns the health care facilities and health professionals are the insurer’s salaried employees. More commonly, the H.M.O. merely contracts with a set of otherwise independent providers that are paid negotiated fees or, for primary care, sometimes annual capitation payments per patient on the doctor’s list.

Usually, in an H.M.O., the insured is asked to select one from a roster of primary-care doctors who regulates referrals to specialists. In principle, under an H.M.O. contract the insured is confined to the H.M.O.’s network of providers for covered services and pays in full out-of-pocket for health care procured outside that network.

Preferred Provider Organizations (P.P.O.): A popular alternative to the strictly limited choice under H.M.O.’s is a Preferred Provider Organization. Under that contract, the insurer negotiates prices with a network of “preferred” providers of care and the insured can contact specialists without a required referral by a primary-care doctor.

For the most part these providers in the network are paid on a fee-for-service basis as well, often X times the Medicare fee schedule, where X could be smaller than 1 but usually exceeds 1, where X is negotiated between the insurer and providers. The insured usually faces an annual deductible and relatively modest copays (dollar amounts, not fractions of the fees) if they obtain care from a provider in the network.

If the insured obtains care from a provider outside the P.P.O.’s network, the insurer will reimburse the insured only at what the insurer considers a reasonable fee, leaving the insured to pay any billed fee above that reimbursement. According to a report by the American Health Insurance Plans, these out-of-network fees can be exorbitantly high, which serves as a natural constraint on the free choice of provider under P.P.O.’s.

Point of Service (P.O.S.) Contracts: These contracts are combinations of H.M.O. and P.P.O. contracts. The insured still must select a primary-care doctor who coordinates the insured’s overall medical care, but patients can procure covered care from providers outside the H.M.O.’s network, albeit at high rates of cost-sharing. In that regard the arrangement resembles a P.P.O.

High-Deductible Health Plans (H.D.H.P.): These contracts couple indemnity- or preferred-provider (P.P.O.) insurance with very high annual deductibles, sometimes exceeding $10,000 for a family. The theory is that by putting the insured’s skin in the game, these plans will give patients an incentive to shop around for cost-effective health care. Some call them “Consumer-Directed Health Plans” (C.D.H.P.’s), because in theory they elevate “consumers” (formerly “patients”) to act as the chief managers of their own health care. However, the requisite information for shopping around has not generally been available to patients, forcing them to function in health care as would blindfolded shoppers in a department store.

What the critics of traditional, government-run Medicare actually find wanting in traditional Medicare is that it basically is classic indemnity insurance. It offers its enrollees free choice of doctor, hospital and other providers, and doctors relatively free choice of treatments, while most private insurers typically no longer do.

In other words, the complaint is that health care rendered under traditional Medicare is unmanaged care. These features, of course, are precisely the reason why in the eyes of the public traditional Medicare is still one of the most popular insurance products.

A case can be made, on theoretical and sometimes empirical grounds, that properly managed or coordinated care can on average yield superior medical treatments, at lower cost, than completely unmanaged care under classical indemnity insurance.

The problem has been and continues to be that this is not the folklore among patients or doctors. The latter, as noted, generally believe they can manage their patients’ care properly without outside interference into their clinical decisions. Among patients and doctors, the term managed care is still not quite respectable.

This can explain why critics of traditional Medicare delicately but nonsensically prefer to decry it as being fee for service rather than as free-choice-of-providers insurance or unmanaged-care insurance.

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Baca shifts course on compliance with deportation program

Los Angeles County Sheriff Lee Baca has reversed his support for a controversial deportation program, announcing Wednesday that he will not comply with federal requests to detain suspected illegal immigrants arrested in low-level crimes.

The sheriff's dramatic turnaround came a day after California Atty. Gen. Kamala Harris issued a legal directive advising that compliance with the requests is discretionary, not mandatory.

Until then, Baca had insisted that he would honor the requests from U.S. Immigration and Customs Enforcement to hold some defendants for up to 48 hours. He was an outspoken opponent of the Trust Act, which would have required California law enforcement officials to disregard the requests in many cases, declaring that he would defy the measure if it passed.

Baca has also been sued by the American Civil Liberties Union for allegedly denying bail to immigration detainees.

Now, he appears ready to do more or less what was proposed in the Trust Act, which was vetoed by Gov. Jerry Brown in September.

The change of heart from Baca, a Republican in a heavily Democratic county, comes as GOP leaders are warming to immigration reform in an effort to counteract dismal support from Latino voters. Last month, Baca closed the 1,100-bed Mira Loma immigration detention center, which earned his agency up to $154 a day for each detainee, after contract negotiations with ICE broke down.

None of those considerations were at play, a Baca spokesman said. The sheriff's reversal was prompted solely by Harris' opinion, which contradicted advice from Los Angeles County attorneys that the requests were mandatory, said the spokesman, Steve Whitmore.

Baca joins Los Angeles Police Chief Charlie Beck, who announced a similar policy in October. San Francisco and Santa Clara counties also decline to honor some types of ICE holds.

The change may not take effect until early next year. Baca's staff must first flesh out the details of the new policy, which would apply only to those arrested in misdemeanors who do not have significant criminal records. The department would still honor federal detention requests for those accused of serious or violent crimes.

Under the federal Secure Communities program, all arrestees' fingerprints are sent to immigration officials, who flag suspected illegal immigrants and request that they be held for up to 48 hours until transfer to federal custody.

Secure Communities has come under fire for ensnaring minor offenders when its stated purpose is to deport dangerous criminals and repeat immigration violators. According to federal statistics, fewer than half of those deported in Los Angeles County since the program's inception in 2008 have committed felonies or multiple misdemeanors. Critics say immigrants have become fearful of cooperating with police.

"The last thing we want is victims to be frightened to come forward," Whitmore said.

ICE officials said Baca's new policy is in line with federal priorities and will affect only a "very small number" of cases.

"The identification and removal of criminal offenders and other public safety threats is U.S. Immigration and Customs Enforcement's highest enforcement priority," the agency said in a statement.

Immigrant rights advocates called Baca's announcement a long overdue breakthrough.

"This will send a very strong message nationwide that in ... the most multicultural city in the nation, the sheriff is there to protect and to serve, not to deport," said Jorge-Mario Cabrera, communications director for the Coalition for Humane Immigrant Rights of Los Angeles.

Supporters of the Trust Act, which was reintroduced in modified form by Assemblyman Tom Ammiano (D-San Francisco) earlier this week, said it is still necessary because detention policies should not vary by jurisdiction.

"It's imperative that California have a uniform statewide policy. It's essential that people not receive different treatment under the law as they're driving up and down the 5," said Chris Newman, legal director of the National Day Laborer Organizing Network.

Baca has not taken a position on the new Trust Act, which is likely to evolve during the legislative process, Whitmore said.

cindy.chang@latimes.com

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Step to the Beat

Going out for a run used to just be about lacing up your sneakers. Now when you head out, you can feel like you’re drowning in tech: GPS watches, sports bands, sweat-proof earbuds, smartphone apps with cadence-matching playlists. And that’s before we even talk about what’s on your feet.

But we wouldn’t subject ourselves to this mountain of gadgetry if it didn’t really help. As our goals become more minute and more ambitious, training “by feel” doesn’t cut it anymore — you need the hard performance data and sophisticated tracking abilities only things like wearable sensors can provide.

Wahoo Fitness, a longtime favorite among plugged-in fitness freaks, has recently introduced a few new activity-monitoring gadgets. I tested the company’s latest real-time pace monitor, called the Stride sensor ($55), as well as a couple of heart-rate monitors. I also tested the Wahoo Key, a $60 dongle for your iPhone that links up to your sensors and passes the data along to your favorite fitness-tracking apps.

I started by setting up the Wahoo Key, which plugs into an iPhone’s 30-pin dock connector. According to Wahoo, iPhone 5 users will need to use a Lightning adapter until the company makes a new design. Setup is pretty easy, but the app guides you through the process, making the instruction manual (which is annoyingly reliant on QR codes) mostly redundant. Once the key was plugged in, I had the Wahoo Fitness app running smoothly in less than a minute. Links to download all the major compatible apps, such as MapMyRun and RunKeeper, were displayed as well.

Although a “keychain” is available for the Wahoo Key, it’s small enough to lose easily. Also, I was nervous about how it protrudes awkwardly from the end of my phone, and I bet it would snap right off if I dropped the phone.

Next, I strapped on the Stride Sensor, which you attach to your shoelaces. I clipped the sensor onto my shoe and it stayed comfortably in place through an entire half-marathon.

The sensor tracks your running pace using a pair of 3-axis accelerometers. It easily links to the phone (via the Wahoo Key), where all the data is displayed and recorded. There’s a slight delay in pace monitoring of only a few seconds, which is totally acceptable. Also, Wahoo lets you program your height to make its readings more accurate. It only lets you go up to 7 feet, so very few runners are going to feel left out.

The collected data could be very helpful to runners trying to teach themselves what various paces feel like. The stats of distance, time and pace are all displayed on the iPhone in large enough text to make them easy readable at the gym or mid-race.

Not content to stop there, I also strapped on a couple of the company’s heart-rate devices: the Wahoo Blue HR Heart Rate Strap ($80), and the Wahoo Soft Heart Rate Strap ($50). The biggest difference between them is that the Blue HR is Bluetooth-enabled (hello, iPhone 5 people!) while the other strap requires the Wahoo Key, in all of its last-generation technological glory.

Of all the goodies Wahoo currently offers, the ability to monitor your heart rate and have your BPM displayed on your phone is the most useful. Target heart rates are essential to a well-structured training program, so this is critical data, and Wahoo delivers it with great accuracy.

According to the Wahoo website, the Blue HR will connect to the iPhone 4s, iPhone 5, the latest-generation iPads and the iPad mini. Be warned: The sensors only talk to each other for a distance of up to 10 feet, and carrying an iPad around the gym could get awkward. I could see a paired iPad being useful on a treadmill, or if you work with a trainer who’s holding one while hovering nearby.

The straps that hold the heart-rate monitors against your chest are also comfortable and shouldn’t bother runners (or cyclists) on even their longer workouts. Wahoo also offers an armband to carry your iPhone while you sweat ($30). The longest run I completed while testing the band was 4 miles long, and the neoprene never chaffed or got uncomfortable, but it kept my iPhone 4 very stable.

For athletes who devour tech like GU on mile 10, Wahoo Fitness is a well-known name. If you’re just getting into tracking your runs or bike rides, the company’s gear is a good place to start. I’d recommend looking at the Bluetooth stuff first, since it works with the newer devices via wireless pairing, and you can avoid the annoyance of the protruding 30-pin dongle.

WIRED Real-time pace monitoring is valuable for undertaking tempo runs. Heart-rate sensors give the number junkies the accuracy and reporting they crave. Gear is comfortable and keeps everything in place without fuss.

TIRED Everything is iOS-centric. Wahoo Key sticks out too far, and doesn’t work with newer Apple devices unless you have an adapter. The Wahoo Key could easily be lost. Uploading music to the Wahoo app isn’t worth the hassle.

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UK’s Kate leaves hospital after morning sickness

LONDON (Reuters) – Prince William‘s pregnant wife Kate left the King Edward VII hospital in central London on Thursday where she had spent four days being treated for acute morning sickness.

Accompanied by her husband, Kate, 30, appeared at the steps of the hospital smiling and holding a bouquet of yellow flowers. Neither she nor William spoke to waiting reporters before being driven way.

Kate, who married the second-in-line to the throne in April last year, has been suffering from Hyperemesis Gravidarum, an acute morning sickness which causes severe nausea and vomiting and requires supplementary hydration and nutrients.

There has been no announcement about when the baby is due, although the prince’s spokesman has said Kate is less than 12 weeks pregnant.

(Reporting by Stephen Addison; Editing by Tim Castle)

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